Autism

What is autism?
Autism spectrum disorder (ASD) and autism are both general terms for a group of complex disorders of brain development. These disorders are characterized, in varying degrees, by difficulties in social interaction, verbal and nonverbal communication and repetitive behaviors.

ASD can be associated with intellectual disability, difficulties in motor coordination and attention and physical health issues such as sleep and gastrointestinal disturbances. Some persons with ASD excel in visual skills, music, math and art.

Autism appears to have its roots in very early brain development. However, the most obvious signs of autism and symptoms of autism tend to emerge between 2 and 3 years of age.

How common is autism?
Autism statistics from the U.S. Centers for Disease Control and Prevention (CDC) identify around 1 in 68 American children as on the autism spectrum. Studies also show that autism is four to five times more common among boys than girls. An estimated 1 out of 42 boys and 1 in 189 girls are diagnosed with autism in the United States.

ASD affects over 3 million individuals in the U.S. and tens of millions worldwide. Government autism statistics suggest that prevalence rates have increased 10 to 17 percent annually in recent years, however, there is no established explanation for this continuing increase.

What causes autism?
Research suggests that the development of autism is rooted in very early brain development. However, in most cases, no single cause can be identified. Research has identified several genes that can cause autism in and of themselves. These account for about 15 percent of cases of autism spectrum disorders. Research has identified more than 100 genes or gene mutations that increase the risk that a child will develop autism.

In most cases, genetics alone can't explain why one person has autism and another does not. Gene-environment interactions appear to be contributing factors. Those environmental risk factors most associated with increased autism risk include advanced parental age at time of conception and prematurity with very low birth weight. Other possible environmental risk factors include maternal diabetes or infection during pregnancy and certain birth complications, particularly those that may involve oxygen deprivation to a baby’s brain.

Can vaccines cause autism?
Over the last 20 years, numerous studies have proven that vaccines do NOT cause autism.  In fact, most physicians and health organizations encourage parents to have their children fully vaccinated to prevent other possibly fatal diseases.

What are the signs of autism?
The following signs may indicate your child is at risk for an autism spectrum disorder. If your child exhibits any of the following, please don’t delay in asking your pediatrician for an evaluation:

• No big smiles or other warm, joyful expressions by six months or thereafter
• No back-and-forth sharing of sounds, smiles or other facial expressions by nine months
• No babbling by 12 months
• No back-and-forth gestures such as pointing, showing, reaching or waving by 12 months
• No words by 16 months
• No meaningful, two-word phrases (not including imitating or repeating) by 24 months
• Any loss of speech, babbling or social skills at any age

Indicators of autism in older children include:
• Impaired ability to make friends with peers
• Impaired ability to initiate or sustain a conversation with others
• Absence or impairment of imaginative and social play
• Repetitive, or unusual use of language
• Restricted patterns of interest that are abnormal in intensity or focus
• Preoccupation with certain objects or subjects
• Inflexible adherence to specific routines or rituals

How is autism diagnosed?
Your child's pediatrician will look for signs of developmental delays during their regular checkups. If your child shows any symptoms of autism spectrum disorder, you'll likely be referred to a specialist who treats children with ASD, such as a child psychologist, pediatric neurologist or developmental pediatrician, for a more specialized clinical evaluation.

A typical diagnostic evaluation may involve a multi-disciplinary team of doctors including a pediatrician, psychologist, speech and language pathologist and occupational therapist. In order to make a diagnosis, these specialists will:

• Observe your child and ask how your child's social interactions, communication skills and behavior have developed and changed over time

• Give your child tests covering speech, language, developmental level, and social and behavioral issues

• Present structured social and communication interactions to your child and score the performance

• Recommend genetic testing to identify whether your child has a genetic disorder such as fragile X syndrome

Making an autism diagnosis can be difficult due to the wide range in severity of the disorder and lack of specific medical testing available.

What other health conditions are associated with autism?
• Genetic disorders- Fragile X syndrome, Angelman syndrome, tuberous sclerosis and chromosome 15 duplication syndrome and other single-gene and chromosomal disorders.
• Gastrointestinal (GI) disorders- These conditions range in severity from a tendency for chronic constipation or diarrhea to inflammatory bowel disease.
• Seizure disorders- Including epilepsy, seizure disorders occur in as many as 39% of those with autism.
• Sleep dysfunction- Many persons affected by ASD have difficulty falling asleep and staying asleep through the night.
• Sensory processing problems- Individuals with autism may have difficulty processing and integrating sights, sounds, smells, tastes and/or movement. They may experience seemingly ordinary stimuli as painful, unpleasant or confusing.
• Pica- A tendency to eat things that are not food, such as dirt, clay, chalk or paint chips.
• Anxiety- These disorders include social phobia, separation anxiety, excessive worry, obsessive compulsive disorder and extreme fears.
• Attention-deficit/hyperactivity disorder (ADHD)- Symptoms of ADHD can further affect daily functioning and quality of life for someone with autism.

Is there any treatment or cure for autism?
There is currently no cure for autism spectrum disorders. However, research has consistently shown that early diagnosis and intervention offer the best chance for improving function and maximizing a child’s progress and outcomes. Early intervention services help children from birth to 3 years old learn important skills. Services can include therapy to help the child talk, walk, and interact with others. Therefore, it is important to talk to your child’s pediatrician as soon as possible if you think your child has ASD or other developmental problems.

As the child gets older, doctors may also prescribe medications for treatment of specific autism-related symptoms, such as anxiety, depression, or obsessive-compulsive disorder. Seizures may be treated with one or more anticonvulsant drugs, and medication used to treat people with attention deficit disorder can be used effectively to help decrease impulsivity and hyperactivity.

Family therapy can teach parents and other family members how to play and interact with their children in ways that promote social interaction skills, manage problem behaviors, and teach daily living skills and communication.

Can adults be diagnosed with autism?
It has become more common for adults who were previously undiagnosed to find out they are on the autism spectrum. Often these adults have mild forms of autism and went undiagnosed before autism became more widely recognized. In cases where their disability was more obvious, many were misdiagnosed with other conditions, such as attention deficit, intellectual disabilities, or mental illnesses.

As autism awareness has grown dramatically in recent years, many young adults and adults have learned the signs and felt there may be a connection between their feelings and behaviors and the symptoms of autism. If you feel you might have autism, it is important to find a mental health professional with experience diagnosing the disorder in other adults. Bring your concerns to your general practitioner and ask for recommendations for a psychiatrist, psychologist or social worker who can help you. It may help to bring a list of the symptoms of autism you feel you may have, including examples of some of the behaviors and feelings that trigger your concerns.

Autism Facts
• Autism can occur in all types of families regardless of racial, ethnic or socio-economic factors.
• Autism is the fastest-growing developmental disability. Prevalence of autism in U.S. children increased by 119.4% from 2000 to 2010.
• Children who have a sibling with an autism spectrum disorder are at a higher risk of also being on the autism spectrum.
• Many individuals on the autism spectrum have exceptional abilities in visual skills, music and academic skills, and many have normal to above average intelligence.

Autism Resources and Information
Autism Speaks
Autism Society of America
The Kelberman Center
Centers for Disease Control and Prevention
The National Institute of Neurological Disorders and Stroke
U.S. National Library of Medicine